Discriminatory attitudes directed at women who nonfatally self-harm have been documented in psychiatric wards and medical settings, especially in Accident and Emergency departments. Such attitudes constitute a “moral code,” which surrounds the act of self-harm and subjects it to negative comparison to accidents, physical illness, and completed suicide. What is less clear, however, are the characteristics of that moral code which governs self-harm in prisons, despite the fact that high rates of self-harm in women’s prisons are well known. Reporting the findings of a research project in one English prison, this article identifies the characteristics of that “moral code” and the way it affects the experiences of women in prison.

“Deliberate self-harm”— acts of self-poisoning (overdosing) or self-injury (e.g., cutting) that do not result in death — has historically provoked a moral judgment in those professionals who treat it. Such judgments negatively value the act of self-harm and lead to the discriminatory treatment of self-harmers in accident and emergency departments and upon psychiatric wards. This article argues that the treatment of self-harmers in such environments has its origins in a “moral code” that negatively values the act of self-harm in comparison to (a) suicide, (b) the accident victim, and (c) individuals considered to be “genuinely” physically ill. The article fulfills two functions. First, it tracks the history of “medicine’s moral code” as it surrounds self-harm in the British context during the period 1950–2000. Then it turns to examine the ways in which patients groups — so-called psychiatric survivors — resisted such discriminatory treatment in the period 1988–2000. Such resistance, the article concludes, creates the opportunity for a democratic dialogue to develop between patient groups and service providers that could potentially ameliorate the deleterious effects of medicine’s moral code. The article’s tone is polemical and is expressly written from a perspective sympathetic to the political claims of “survivors,” which the authors conclude forms a central component in the development of democratic practices within medicine and psychiatry.

This article considers certain historical and theoretical aspects of Ken Loach's 1971 film about mental illness, Family Life. Historically, it explores the film's influences, particularly that of the 1960s ‘anti-psychiatry’ and counter-cultural figure, R. D. Laing. To this end, the article examines in detail a contemporaneous critique of Family Life, namely Peter Sedgwick's hostile review for Socialist Worker in 1972. In the light of this critique, the article then reconsiders, theoretically, Loach's strategies of socialist-realist representation in Family Life, particularly as they relate to, firstly, mental illness and institutional psychiatry; and secondly, the distinction drawn by Raymond Williams between artistic and political forms of representation.

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